Contents
• Executive summary
• Introduction
• Aims and objectives
• Methodology
• Part 1. Focussed literature review
• Part 2. Qualitative evaluation of SCAN
• Part 3. Quantitative evaluation of SCAN
• Part 4. Economic evaluation of SCAN
• Integrated findings from evaluation of SCAN
• Recommendations
• References
• Appendix 1

This research evaluates the impact of the fast track priority referral and assessment system for individuals experiencing a suicidal crisis, known as Suicide Crisis Assessment Nurse (SCAN) Service; operated in Cluain Mhuire and Wexford. The research utilised a mixed method, exploratory sequential design.

A focused literature review concluded that any suicide prevention strategy needs to be investigated comprehensively and methodically to ascertain the potential benefits of risk assessment and collaborative working between primary and secondary care.

Without SCAN, all professionals recognised that referral and/or admission to mental health services was often a ‘default’ position; necessitated more by lack of appropriate community based facilities than by clinical need. Clinicians were frustrated by the delays and uncertainty that regularly accompanied the process of referral/admission, whilst navigating a cumbersome process and the de facto development of a possibly inappropriate psychiatric history could be the outcome for clients.

GPs, clients and CMHTs described SCAN as providing a valuable, accessible and timely gateway between primary care and mental health services; allowing for expedited admission, referral for on-going mental health intervention in the community or management in primary care.

Alongside this gateway role, SCAN was found to have a therapeutic value that was identified as pivotal by clients; apparently contributing to the perception that they were being ‘taken seriously’.

Recommendations:
• GP training sessions in suicide/self-harm should be embedded into continuous professional development programmes provided by their primary care organisation.
• Clear guidelines/protocols need to be in place to identify what are, and are not, appropriate referrals to SCAN and how the referral process should be managed.
• Clear guidelines/protocols need to be in place to identify who is responsible for follow up following SCAN assessment
• The full range of demands on SCAN staff need to be acknowledged and top level management commitment to appropriate governance, support and supervision needs to be maintained and regularly reviewed.
• The maintenance of adequate staffing levels for SCAN needs to be prioritised, including appropriate administrative support.